BGL 52 asymtomatic, now stable

Billy was diagnosed the 28th, we're feeding FF wet low carb diet. We've suspected that with the FF diet the dose the vet gave us might be too strong because we had some low nadirs, so we backed down from 2 units to 1.5.

Just tested Billy, BGL was 52. He seems his normal self, even ran into the kitchen when he heard me opening a can. We gave him a can of the higher carb gravy FF, and he ate maybe half of it. We also gave him 6-8 of his favorite crunchy Whisker Lickins treats, which he also ate. We will test again in an hour, to make sure his levels are coming back up. We did not give him any insulin. I think he's all right, but we've never done this before. Happy to get any advice.

 

Hi! I'm not one of the "regular" helpers here, but I wanted to pop in and just say that at 52, you'll want to check more often (even every 20 mins) to make sure he's not going too low, even with food. Also just know that BG bumps from food are temporary, so you'll want to keep checking until you're certain he's coming up on his own. I think you'll be alright too; just keep checking him - and hopefully one of the experts will chime in too.

 

Thank you. About to re-check now.

BGL up to 64. Will test again to make sure it keeps rising. I'm up and will keep monitoring.

 

I'm not comfortable giving dosing advice, but it's late and the board is quiet tonight. Sometimes diet alone can bring blood sugar down quite a bit, and you need to be careful when changing diet at the same time as starting insulin. It looks to me like 2U is definitely too much at this point - many members here recommend starting with 1U of Prozinc with a newly diagnosed cat, and increasing by quarter units if needed.

In between testing, you could read this (if you haven't already) - lots of great advice here.
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Any updates?

 

He is still alert and acting normal. Now he's chowing down on some high carb dry food. We started him out with the FF almost immediately, as soon as he started eating again after the vet visit. Never gave him the Hill's the vet recommended. The vet's advice was give him 2 if he was eating and 1 if he wasn't. My fiance and I agree that 2 seems too much, but were afraid to back him off too fast. So we did 1.5, but got this super low. We plan to stick to 1 unit from now on and see if we can keep it there consistently and try to get some regular readings. I also plan to take Billy's spreadsheet to the vet so he can see what's been going on. He's a good vet, but he gave us instructions thinking Billy was going to be on that high carb dry.

 

Thanks for the update. Sorry you're having to deal with this so soon after diagnosis. It gets easier with time. I wish I had more advice to offer. I'll be around for about another hour, so I hope someone else can sit with you tonight if you need it. Please keep this thread updated.

 

Oh! That reminds me. You don't want to feed tooooooo much at once when their bg is low, because if you do need to continue steering them up with food, they may get full and not want to eat any more.

 

Thank you! We were freaking out a little bit. We'll cut back on the feeding and let him rest.

 

Please keep us posted on his numbers, and definitely feed as needed. Just don't overdo it.

 

How's everything going? I'll be off soon and was wondering if you've retested Billy.

 

Getting ready to re-test now.

Up to 88. And he wanted to eat a little more, so we let him. We will continue to monitor him, but he seems fine and has normal behavior. In fact, he seems annoyed we're bothering him so much.

 

Sounds good. Thanks for the update. You're doing everything right - I'd get a couple more checks in just to be absolutely sure he doesn't go lower again. Unfortunately I'm off now - hang in there and feel free to put your 911 tag back up if needed! Give Billy a hug for me.

 

Thank you for all your help, and for hanging with me during this. It was our first time having a number that low, and my fiance and I were scared. You helped more than you know. You rock!

 

Aww, thanks - I know how stressful it is. I actually popped back on to say that Rocket's BG can go up by around 30 points with food alone, so... 50-ish to 80-ish could still be food-influenced. I'd recommend a couple more tests before bed if you can, and maybe get up in an hour or hour and a half after that to check again. I just want to be sure you're safe before I go to bed. Big hugs and goodnight

 

I'm testing again at 4am, then setting an alarm to test again after that. Too worried to not test, but thank you so much for your comment. Let's me know I've got the right plan going.

 

It's 4am, and Billy's latest reading is 166. I will test again in a couple hours to be safe, but I think we're out of the woods.

 

I am going to ask @MrWorfMen's Mom to have a look at what dose you should be giving. I have not I used Prozinc.

 

Think you are out of the woods too. Good call on not giving insulin with a pre-shot test that low.

Some comments on your SS with the high carb foods and treats you gave for this PM cycle would be helpful to see.

Don't know what your and your fiance work schedules are like, but you might think about when you can get some BG tests in during the +3 to +7 hour times.

Bet you are tired this morning.

With all that high carb food last night, I would not be surprised if Billy shows a high AMPS this morning.

I have not used Prozinc either, but even with a high AMPS, I'd back the dose down to 1 U max and see what happens from there. Especially given the fact you are trying to feed the low carb food. Dry food takes a bit longer to digest then the wet so dry food and treats takes more time to have an affect on the BG readings.

Having some higher carb wet food in your 'toolkit' can be helpful. The Fancy Feast (FF) Grilled in Gravy and Sliced in Gravy and Marinated Morsels in Gravy are all in the 12-15% carb range, what we think of as medium range carb percents. The FF Gravy Lovers line are mostly 15% carbs with the Beef Feast being an exception at 20% carbs. Buy a few cans to have on hand and write the carb percent on the can somewhere with a permanent marker.

 

Wow! Billy has been through a lot in just the last week.

Is he eating the Fancy Feast wet food ok? Or is it still a struggle? Which of the Fancy Feast foods does he like? pate style, grilled, sliced, chunky, roasted?

Forgot to mention that after low BG levels, some cats can be extra sensitive to insulin. Another reason for dropping the dose down a lot.

 

That certainly was some excitement for you last night but you handled it well. So glad Karen and Deb were here to provide support and advice.

I agree the dose needs to be reduced and would suggest dropping the dose to 1u and getting some mid cycle tests in the +3 to +7 post shot timeframe to see how low Billy's BG is dropping. The low of 52 indicates the dose is too high but the fact that low occurred at the end of the cycle may also suggest the that Billy is getting extremely good duration from the insulin. It also makes me wonder if he may have dropped even lower earlier in the cycle.

Billy's BG this AM will likely be high again possibly from the higher carb food last night but also from a phenomenon called bouncing. Bouncing happens when BG drops quickly, drops a lot or drops to levels that the cat has become unaccustomed to which is relative. Billy stayed in safe numbers last night but he did drop considerably lower than he has been. Bouncing is normal and just has to clear on its own which can take up to 6 cycles so don't be concerned if you see higher numbers right now and don't be tempted to increase insulin dose.

If BG drops below 90, then I'd reduce the dose further to 0.75u and again test to see how low that dose is taking BG.

 

Thanks everyone for the help. Fiance tested again at 6am, and the reading was 227. I'm expecting a high reading when I test him pre-shot at noon. And I will test Nadirs today to be safe. Yesterday he ate at regular intervals, and was alert and himself, so if he dropped lower than 52, he showed no symptoms. We were trying to give his ears a rest, but too nervous not to test at Nadirs today!

Here's what's happened so far, and I'll try not to write a novel about it. (Joke--I write novels for a living) We noticed Billy was ill on the 27th. Not eating, lethargic, a little vomiting, but didn't seem in immediate trouble. Took him to vet on 28th. Vet tested blood, urine, and did xray to rule out a blockage. Sugar was over 500. Urine showed sugar and signs of a low to mid-level infection. Billy got a shot of Cerenia for nausea and a shot of Cefazolin for the infection. Vet proscribed insulin, and said give him 2 units if he ate and 1 if he didn't. Vet sent fiance and Billy home with a bag of Hill's dry prescription food. Vet said he wanted to see Billy again in two weeks. I took one look at ingredients of the Hill's, and said I was not feeding Billy that stuff. Researched online, found this site, read a ton. Bought Fancy feast. I already had a meter, (I was diagnosed diabetic a year ago, but kicked it to the curb.) Bought Billy his own stabby-stab, because I suck at doing it by hand and he doesn't mind the click. Made a rice sock and got some Vaseline.

Billy did not eat anything until evening of the 29th, and then only a few bites. Since then, appetite has been increasing daily and now he is eating more normally. We feed several smalls meals through the day, and pull up food 2 hours before dosing time. Billy loves wet food and he loves Fancy Feast, the amount he is eating has been steadily increasing, and yesterday was the first time I thought he ate a normal amount, asking for food, and sometimes cleaning his plate in one sitting. That's why we got complacent. He ate a lot yesterday, and the 52 reading shocked us.

Because of lower Nadirs on the 1st, we reduced dose to 1.5. We plan to do no more than 1 for the foreseeable future, even if he has higher numbers. Last night was scary. We had two cans of a high-carb Friskies flavor and his favorite crunchy cat treats in his emergency Hypo kit. (thanks again to this site, we were prepared.) He ate about 6 Whisker lickins treats and 1/2 can of FF Gravy lovers immediately. Over the next few hours, he had a few bites of high carb dry, about 1/3 a can of the Friskies high carb, and half a can of FF Classic. BGL climbed steadily. We probably overfed a bit, but because his appetite is only now returning to normal, he didn't overdue it. He was happy to have a little bit of everything.

Left him with some of the FF Classic, woke up at 6 AM to a clean plate. Gave no food from 10am to Noon, pretest.

Tested at noon-- 280. Yeah, it's higher, but not as high as I was expecting. Was too worried to give a full 1 unit dose. Gave him .5 instead. Didn't want to skip, but was afraid of more lows. Will test Nadirs to keep an eye on him. Appetite was awesome. Ate an entire can of FF Classic for the first time.

But now I'm wondering. Was his sugar high only because he had an infection? Is he just doing so well on FF Classic and FF Naturals that we'll have to stop Insulin? I will test Nadirs today and we'll see how he's doing. Happy for any advice. Love this site. You are all rock stars. I feel like if we'd just did as the vet said, and not been testing his sugar, Billy would have had serious trouble by now. Love our vet, but wonder how much experience he has with kitty diabetes.

 

Glad to hear his appetite is healthy and he's liking his FF.

Yes, an infection can cause elevated BG and by how much is a very individual thing. There is also vet stress which most kitties experience so when the vet checks BG in office, it is often elevated and sometimes in some cats by as much as 100 or more points. Add in an infection and an elevated BG is not unusual. Did the vet run a fructosamine before prescribing insulin or just do a glucose test on blood and urine? Fructosamine will tell you if BG has been elevated over a period of the past 2 to 3 weeks much like an A1C in humans and should be done as part of the diagnostic testing.

Of course if Billy's diet was higher carb before the change to lower carb can also have a significant lowering effect on BG. Once the vet stress passes, the infection is dealt with and the diet is changed, it's not unusual for the cat to require less insulin and in some cases go into remission. If a fructosamine was not done, that leaves the question of whether the diagnosis was correct to begin with or the elevation was a transient issue due to the stress and infection. In this case, since you are now home testing and Billy's BG is above normal today, it seems he likely is diabetic.
vets don't get a lot of training in diabetes and what they get covers multiple species. Most clinics don't deal with that many diabetic cats and probably have far more diabetic dogs as patients. Unfortunately, many vets treat cats like dogs and they shouldn't be treated the same at all. If your vet is good with everything else and is willing to work with you as a partner rather than a dictator, then I'd give him/her a pass and just take control of this situation yourself. We can help you do that. Most of us do not consult with our vets about the diabetes and just see them for other issues and yearly checkups. Diabetes is a 24/7 condition and it isn't one size fits all treatment wise so by taking control yourself and home testing you have the power and ability to keep Billy safe and get him regulated to keep him healthy for years to come.

 

Again WOW! Good job.

So you "kicked diabetes to the curb" for yourself and you have changed the diet for Billy to a low carb one. Best part is Billy is eating more.

I see your signature says Billy is "fat", but you are working on getting him to lose weight. Our pets being overweight can be a contributing factor for diabetes.

Kind of expected the BG's to bounce higher this morning with all that high carb food last night. Better to get the BG's up to a nice safe number > 100 mg/dl on a human meter.

Was his BG higher because of the infection? Maybe, but high carb food often keeps the BG's higher as you found out while 'feeding the low' last night.

Keep us in the loop and Billy may be one of those kitties that gets regulated soon and the low carb food makes all the difference. He may even go OTJ (off-the-juice, insulin being the juice) quickly with the change to low carb food. Impossible to tell at this point. Happened for my Wink.

 

What kind of books do you write? Fiction or non-fiction? Maybe we've read some of your works.

 

The answer to this is that I don't know. Vet did a test called Blood Glucose AVH, but I don't know what that means. Vet is awesome. He has always been supportive of us taking a pro-active stance with our pets. I think he does see more dogs than cats, so that may be what's going on there.

My gut reaction so far is that Billy does have diabetes, but we may have a decent chance of getting him into remission. Even if we don't, we'll do our best to get him happy and regulated.

His diet pre-vet visit was moderate carb. Origin Cat and Kitten (a low carb dry) Some Rachel Ray dry food (a moderate carb dry) and canned food once a day, (Friskies, probably moderate to high carb.) I think his biggest issue is that he's too dang fat, something we'll work on now that he's no longer free feeding, once we get him stabilized.

 

Agree! I think poor fat boy had his weight catch up to him. He's 16 pounds, and I think he would look good at 12-13 lbs. Now that we are no longer free feeding, I think we can get his weight down once we get his BG stable.

I write speculative fiction, mostly ghost stories, zombies, some witches. Mostly thriller and mystery, a couple romances. Author name is Julianne Q Johnson.

 

My gut says the same thing. Bottom line, happy cat = happy you. You are helping to make him feel better with the insulin and food. He might not appreciate the shots and food change and all, but down the line he'll be better for it.

A vet that is willing to work with you instead of telling you 'this is the only way' is priceless.

How are the 5 P's preening, peeing, purring, pooping, playing? Improvements in those categories show what you are doing is working. It's more of a visual 'how is my cat doing' then only looking at the BG levels. Another way of monitoring a cat's health.

I had a civie (non-diabetic) and the vet said 'He needs to lose a couple of pounds.' Got him from 16 to 14 lbs and she said 'He could stand to lose a couple more pounds. I'd like to see him at 12 pounds. Meal feeding only 2 times a day.' Did that, took a long time, slow gradual weight loss on vet recommended dry prescription food. If I knew then what I know now about low carb canned foods also being lower in calories, I would have done that food change and had a much easier time and he loved canned food. He was always hungry on the dry. Always.

 

He's doing all the 5 P's, and has been the last couple days. That's one of the reasons we were shocked by the low BG last night, he's acting so normal! He's grooming, snuggling with his bff kitty, and washing his bff kitty too. Peeing was never an issue. The purr came back first, then he started talking again, then the others followed quickly. Played a bit with a new fishing pole type toy. Really seems his usual self again. Whatever the cause of the infection was, I think the antibiotic shot did the trick.

Plan to take he weight loss slow and steady. I do think the lower cals on the wet food will help enormously. He can have more bulk and moisture, which will help him feel more full on less food.

Fiance Brian talked to the vet today. Only had an issue with the fact we are using a human monitor. They insist the curve is done on a pet monitor. No worries. Vet doesn't want a curve until the end of the month. We'll get a pet monitor and just use it for the curve so he doesn't have to spend the day at the vet.

 

Normal is good! Normal is fantastic! Glad to hear he got his purr back. Playing can help to burn off some of those extra pounds too.

Before pet specific monitors, there were only human glucometers used for cats and dogs. For something like 3 decades. Disappointing that your vet is not willing to work with you with the human glucometer BG readings.

If cost is not a consideration, then having a pet specific meter could work, but be warned the test strips are expensive at $1-2 each and the meters themselves can be pricey.

A curve is giving you a general 'shot in time' picture of how your cat is doing. Daily home testing is giving you a good idea of what is going on, so I don't see a need for a vet visit for a curve. At home should be sufficient. Fructosamine test not likely to give you much additional information either, so I'd skip that.

Personally, I'm betting that Billy will be in remission by the end of the month.

Definitely keep it slow on the weight loss. Wink lost weight way too fast for my comfort with the food change. But he did get back to a more normal weight over a couple of months. Kept up the portion control with the food for the rest of his life and he never needed insulin again. Had to use meal feeding so he didn't over eat (or steal the other cats food).

 

I completely understand about the human meter and how much knowledge has been amassed using them. That's why we're using one. I love that the numbers used on this site correspond to the human meter, and I don't have to try to convert. My guess is the vet is used to the pet meter, and not used to the human meter numbers. If we need to buy a pet meter for the curve we will, and just use it for that.

But I think you are right. I think he may be off insulin by then. That makes me think we'll put off buying a pet meter for a couple weeks and reevaluate the need for one then. We'll spend what we need to to get Billy healthy, but no need to rush into an added expense.

 

I wonder if the vet would let you borrow their meter for the day, if you buy the strips you use. I would hate for you to pay that much and only ever use it one day. Also check out our Supply Closet forum. Occasionally people sell or give away meters they no longer need at a reduced price.

 

Just wanted to pop in and say I'm glad everything went ok, and that Billy is doing well this morning! I'm looking forward to seeing how he does over the next couple weeks too.

 

@Keskat&Rocket did great helping you out last night by the way. Karen may not give dosing advice, but the general information she gave you to work you way through the low numbers was spot on. Good job Karen! Thanks for being there so late, I'm never able to be on the board that late anymore.

 

Thank you I'm just glad everything worked out ok. I remember very clearly the first time Rocket went low -- it's super stressful, and I'm very grateful for the help we've gotten here!

 

Keskat&Rocket is completely awesome! Gave me good advice, helped keep me calm. Can't thank you enough!

 

Thank you Juls. Fingers crossed that you're able to get Billy into remission!!! Give him a huggle for me.